Impact of Maternal Educational Attainment Status on Birth Outcomes by Maternal Nativity Status of Korean Americans

This study contributes to the limited number of studies of Korean Americans' birth outcomes by examining: (1) which subgroup of Korean American is more disadvantaged by examining the effect of maternal race and nativity and educational attainment on birth outcomes; (2) how the "healthy migrant effect," which explains the association of maternal foreign-born status and favorable birth outcomes, and "epidemiological paradox," which explains the association of low socio-economic status and favorable birth outcomes are applied to Korean Americans; and (3) what are the protective factors and risk factors of birth outcomes that could be applied to the general population in the U.S.;Statistical analysis was performed on data from the Linked Birth and Infant Death Cohort Files for 2000–2004 compiled by the National Center for Health Statistics. The study sample includes 3,168 U.S.-born and 46,504 foreign-born Korean Americans, and 49,672 matched non-Hispanic whites using the Propensity Score Matching. Binary logit for low birth weight and preterm birth and multinomial logit for three categories of birth weight are employed.;Multivariate logistic regression demonstrates being a foreign-born Korean American significantly decreased the odds of low birth weight (OR=0.1), preterm birth (OR=0.2), and prematurity (OR=0.004). Thus, the healthy migrant effect is present in low birth weight, preterm birth, and prematurity. Also, maternal college and higher education significantly decreased the odds of low birth weight (OR=0.78), preterm birth for U.S.-born (OR=0.75) and for foreign-born Korean Americans (OR=0.88), prematurity (OR=0.79), and IUGR (OR=0.75). Therefore, maternal educational attainment turned out to be a significant protective factor, and there was no evidence for the epidemiological paradox among Korean Americans.;These findings have policy implications. The policies aimed at promoting better birth outcomes of Korean Americans can have implications not only for U.S.-born, undereducated, or underserved Korean Americans, but also for other populations who fit these characteristics. Policies aimed at enhancing better birth outcomes of the whole populations in the U.S. should focus on protective and risk factors of birth outcomes found in this study.